Individual
IGNACIO ACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1808 VERDUGO BLVD, SUITE 409, GLENDALE, CA 91208-1487
(818) 790-8020
(818) 790-9313
Mailing address
1808 VERDUGO BLVD, SUITE 409, GLENDALE, CA 91208-1477
(818) 790-8020
(818) 790-9313
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A26640
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004033429
AETNA ID
—
01
—
000767453
APWU ID
—
01
—
00A266400
BLUE SHIELD ID
—
05
—
00A266401
—
CA
01
—
020011428
RAILROAD MEDICARE
CA
01
—
300000306091
PLAN HANDLERS ID
—
01
—
953131650
BLUE CROSS ID
—
Enumeration date
06/21/2006
Last updated
01/22/2008
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